Heavy EGR required on diesel engines for future emission regulation compliance has posed a big challenge to conventional turbocharger technology for high efficiency and wide operation range. This study, as part of the U.S. Department of Energy sponsored research program, is focused on advanced turbocharger technologies that can improve turbocharger efficiency on customer driving cycles while extending the operation range significantly, compared to a production turbocharger. The production turbocharger for a medium-duty truck application was selected as a donor turbo. Design optimizations were focused on the compressor impeller and turbine wheel. On the compressor side, advanced impeller design with arbitrary surface can improve the efficiency and surge margin at the low end while extending the flow capacity, while a so-called active casing treatment can provide additional operation range extension without compromising compressor efficiency. On the turbine side, mixed flow turbine technology was revisited with renewed interest due to its performance characteristics, i.e., high efficiency at low-speed ratio, relative to the base conventional radial flow turbine, which is relevant to heavy EGR operation for future diesel applications. The engine dynamometer test shows that the advanced turbocharger technology enables over 3% BSFC improvement at part-load as well as full-load condition, in addition to an increase in rated power. The performance improvement demonstrated on an engine dynamometer seems to be more than what would typically be translated from the turbocharger flow bench data, indicating that mixed flow turbine may provide additional performance benefits under pulsed exhaust flow on an internal combustion engine and in the low-speed ratio areas that are typically not covered by steady state flow bench tests.